Maki GRLE, Ivana GRLE, Goran VRGOÇ, Goran SPORİS

Diagnosis of Acute Knee Injury-Comparison of The Results of Clinical Examination, MRI And Arthroscopy-Save Clinical Tests From Extinction!

ABSTRACT INTRODUCTION: The aim of this study was to compare the physical exam and magnetic resonance imaging (MRI) results, with results of arthroscopy, in patients with acute knee injury. The second aim was to compare the clinical results of patients who underwent arthroscopic meniscetomy after 3 weeks, 3 and 6 months from injury. METHODS: From January 2003 to November 2008, there were 159 patients which underwent arthroscopic surgery on the knee. 121 patients with acute injury, 99 men and 22 women, age 13 to 62 years, 67 right knee/54 left knee. The orthopaedic surgeon performed test to examine the meniscus for tear, test to examine for stability of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). Also were collected information of range of movement (ROM), and patients had to fulfil the Lysholm knee questionnaire. Postoperatively were done the same measurements. RESULTS: The results showed no statistical difference for the accuracy of the initial diagnosis between clinical examination and MRI (p = 0.640). The results were similar for the rupture of the meniscus (p = 0.948) and meniscus and ACL (p=1.000). DISCUSSION and CONCLUSION: Comparing the results of precision, sensibility, specificity, predictive positive and negative value of clinical and MRI tests and comparing them to the results of arthroscopy, there was no statistically significant difference. The results of Lysholm and ROM showed no statistical difference between three groups and statistically significant improvement of postoperative results when comparing them with preoperative results in all groups.

Akut Diz Yaralanması Tanısı-Klinik Muayene, MRI ve Artroskopi Sonuçlarının Karşılaştırılması-Klinik Testlerin Yok Olmasından Sakınmak!

ÖZ GİRİŞ ve AMAÇ: Bu çalışmanın amacı akut diz yaralanması olan hastalarda artroskopi sonuçları ile fizik muayene ve manyetik rezonans görüntüleme (MRG) sonuçlarını karşılaştırmaktır. İkinci amaç yaralanmadan 3 hafta, 3 ve 6 ay sonra artroskopik meniscetomi uygulanan hastaların klinik sonuçlarını karşılaştırmaktı. YÖNTEM ve GEREÇLER: Ocak 2003'ten Kasım 2008'e kadar, dizde artroskopik cerrahi geçiren 159 hasta vardı. Akut yaralanma olan 121 hasta, 99 erkek ve 22 kadın, 13-62 yaş, 67 sağ diz / 54 sol diz. Ortopedik cerrah, menisküsün gözyaşı incelemesi için test yapmış, anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial kollateral ligament (MCL) ve lateral kollateral ligament (LCL) stabilitesini test etmek için test yapmıştır. Ayrıca, hareket aralığı (ROM) hakkında bilgi toplandı ve hastalar Lysholm diz anketini yerine getirmek zorunda kaldı. Postoperatif aynı ölçümler yapıldı. BULGULAR: Sonuçlar, klinik muayene ile MRG arasında başlangıç tanısının doğruluğu açısından istatistiksel bir farklılık göstermedi (p = 0,640). Sonuçlar menisküs rüptürü (p = 0.948) ve menisküs ve ACL (p = 1.000) için benzerdi. TARTIŞMA ve SONUÇ: Klinik ve MRG testlerinin kesinliği, duyarlılığı, özgüllüğü, prediktif pozitif ve negatif değerlerinin karşılaştırılması ve bunların artroskopinin sonuçları ile karşılaştırılmasında istatistiksel olarak anlamlı bir fark bulunmadı. Lysholm ve ROM sonuçları, üç grup arasında istatistiksel olarak anlamlı bir fark göstermedi ve tüm gruplarda ameliyat öncesi sonuçlarla karşılaştırıldı- ğında postoperatif sonuçlarda istatistiksel olarak anlamlı iyileşme görülmedi.

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